My dad is now taking carbidopa/levodopa for parkinsons. 1 1/2 yr ago when he was first diagnosed, he barely had any tremors. Just the shuffling steps and the bent head (down). Also the stiffness of joints.

What is the next step - medicine wise - for him, that might help some. He now has more tremors. And he crumples, sort of, when he tries to walk or get out of the car, sometimes! He says he feels dizzy, but I think it is just his alzheimers and parkinsons illnessess! When he is tired or stressed, he has more tremors (much more that 1 yr. ago!).

What is the next higher/more helpful medicine, that might stop most of his tremors? Is the weakness in his legs, due to his parkinsons? Or could it just be a part of his low blood pressure?

If you do not know the answers to these ?s, please tell me where I might find them. Thanks. Take care. Wannabe

I'm hoppy and at 49 have had pd for about 13 or 14 years. Advice, meds, etc....

First you must love your dad if you are taking the time to find out more. Just always remember he's your dad even when he does strange things or can't hardly get out of bed. I have taken so many meds, Sinimet (carbidopa/levidopa) Mirapex, Tasmar, eldypril, Tocapone, requip, and several more that I don't remember rignt now. Sinimet, IS the gold standard! the others help the sinimet to last or increase the effects of it.
Suggestions, MAKE SURE YOUR DAD is seeing a movements disorder nueorologist. NOT JUST A NUEROLOGIST! There are centers for excellence on other websites, you can find them there. It is the difference between taking you Ferrarri to Joe's fixit shop and the Ferrarri dealer. I used to drive 600 miles to the doctor, she was worth the trip.

His doctor, if he's any good can or should be able to, adjust and know the current meds on the market. If he or she doesn't GO ELSEWHERE. You don't have to feel that all docs are alike, they are NOT. You only get so many years after the diagnosis... I was very lucky to have DBS surgery, and it has gave me a new chance, I'm not 100% but a heck of a lot better than before.

Thanks for the reply. I will also check out the meds you mentioned. I do not know if my father would go to another specialist. He is 78 yrs. old and has alzheimers also. So, some drs. would just write him off! But, the neurologist that my dad goes to, listens to my suggestions, so maybe one of those additional meds, might help my dad for a while.

I was diagnozed in Jan. 2000,but my symptons started in 1994 with a slight limp like my knee would jerk. Then I realized that this was only affecting my right side. I went to different specialists and they said I had peripheral neuropathy(PN), which is only a sympton. My mom had the same diagnosis back in 1980 and her brother and niece had this PN. So I didn't pursue this anymore after about 1998 for I figured it was genetic. My mom was still doing all right so I figured I would be all right. But in 1999 I was declining, I was getting rigid and couldn't get up out of the chairs or roll over or scoot over when laying down. Then I got the flu in winter of 1999 which hung on for a couple of months. I got really weak and couldn't even curl my hair with the curling iron. That is the background of my Parkinson. I went to a well known clinic in California. As soon as the neurologist seen me walking, he told me I had PD. There are no tests for PD they look at your physical symptons.
I started taking Carbidopa/Levodopa CR 50-200 4x per day. Within a week i was able to sleep for about 4 hrs. It was like a miracle my body responded to the medicine very well which confirmed I had PD. About a 1 1/2 yrs. later he prescribed Comtan 200mg 3x per day. Comtan is only used with Carbi/Levodopa. My carbi/levo wasn,t working as well. It breaks down the carbi/levo in your stomach so the medicine can reach your brain sooner. When taking Carbi/Levodopa you have to be careful of what you eat protein interferes with the absorbtion of the medicine. It is better on a empty stomach. My dosages have changed because your body gets used to the Meds and stops working as well.
My Meds I take now are carbidopa/Levodopa 25/100 - 1-1/2 tabs 7x per day, Comtan 100mg 7x per day, Amantadine 100mg 3x per day which was added in april 2005, and also REQUIP 2mg 5x per day. My doctor added Requip for I was taking about 1500 to 1600 mg of carbi/levo per day. I am down to about 950 mg per day. The only problem is i am starting to fall easily because my balance is off. Since I started taking the new meds in 2005 I have been falling. Last week I fell twice. Good Luck with your Dad and if you want to hear more write back. Each person with PD is different. Also I was fortunate I don't have the tremor that is usually what takes people to the doctor. Also there are some great sites on the internet under Parkinson's. You need to educate yourself because the doctors don't always tell you the details like protein will interfere with the absorbtion, such as drinking milk with your pills

Thanks for the reply and the information. I really appreciate your help!

I am glad that you said that at the end - about how you should not drink milk with your parkinsons meds. I bet that my dad drinks his with milk, at least 1/2 of the time! He has never had his meds upped. He has been on the same one and the same dose for 1 1/2 yrs. He is starting to get more tremors. Even he noticed it, and he has mid-level alzheimers! He says that his back hurts more too. Is that a symptom of parkinsons? He says that is his arthritis.

I guess next time we go to his neurologist, we should ask about more or upped dosage of what he is already taking! Maybe in mid December, or the first of Dec.?! He could probably do more, if he could walk better and move better.

Do you know if dizziness is a symptom of parkinsons? My father gets dizzy a lot and he also sleeps a whole lot! Of course either/both could be a symptom of alzheimers?!

Thanks for the info. I do need to research more, especially before we go back to his specialist!!!

Hi Wannabe,
Thanks for your reply. It definitely sounds like your dad needs a change in his medicine. My neurologist specializes in Parkinson's, and he is also a Movement Disorders Specialist. He is my third neurologist and I am very happy with him. It is about a four hour drive but it is worth it. I mentioned that protein interferes with the absorption of the medicine, an example that I like is your Carbi/Levo and the protein are competing down the same artery to your brain. And of course that will keep your medicine from doing its job. Also constipation is one other sympton that PD patients get because our muscles aren't working as fast, that also affects the absorption of the Carbi/Levodopa. I don't know if I mentioned it before but I've never had the tremor thank God. Each person is different so the doctor has to look at your individual case.
I haven't seen the back as being a problem. I've never had any problems with mine. Stress does make our symptons more pronounced. Go to the web site and type in Parkinson's Disease and Nutrition. There is alot of information out there. The more you know the better and write down your questions before your Dad goes to the doctor that way you won't forget. We are our own best advocates, for the doctors have lots of patients.
Good Luck and God Bless You! Grama Hope

My dad is now taking carbidopa/levodopa for parkinsons. 1 1/2 yr ago when he was first diagnosed, he barely had any tremors. Just the shuffling steps and the bent head (down). Also the stiffness of joints.

What is the next step - medicine wise - for him, that might help some. He now has more tremors. And he crumples, sort of, when he tries to walk or get out of the car, sometimes! He says he feels dizzy, but I think it is just his alzheimers and parkinsons illnessess! When he is tired or stressed, he has more tremors (much more that 1 yr. ago!).

What is the next higher/more helpful medicine, that might stop most of his tremors? Is the weakness in his legs, due to his parkinsons? Or could it just be a part of his low blood pressure?

If you do not know the answers to these ?s, please tell me where I might find them. Thanks. Take care. Wannabe

Hi!

I would ask his doctor to send him for an MRI (magnetic resonance imaging) of his neck to rule out the possibility of Cervical myelopathy.

Cervical myelopathy is when the spine deteriates with age. it can close around the spinal cord in areas of the joints and cause problems with ballance, dizziness and stooped posture with the head drooping forward. Does he ever complain about his neck being sore sometimes? or shoulder pain? or pain that runs down the arms? does head droop forward? DOES HE FEEL DIZZY?!!!!! Dizziness is the biggest symptom.
It can effect the basal ganglia part of the brain also by restricting the spinal fluid to the brain.

I am not a doctor, but my cousin had the symptoms you mentioned, and I had them also, the MRI showed Cervical myelopathy. The doctors fixed the problem for my cousin. I'm still holding off until it gets worse, because my dizziness is not as often.

I have both, moderate late stage Parkinson's and Cervical Myelopathy. When the dizziness from the spinal cord closing too much, my tremors get much worse. also my ballance.
It was the dizziness that caused my doctor to send me for an MRI.

Thanks for the information. I will check it out. Because a lot of the ?s you asked, I said yes to. I will do some research and then ask his doctors about that.

He is 78, how old is your cousin? I just wonder if fixing it means having an operation? Any kind of procedures make my dads alzheimers worse!!! Are there not treatments or non surgical procedures to help with this?

Thanks for the information. I will check it out. Because a lot of the ?s you asked, I said yes to. I will do some research and then ask his doctors about that.

He is 78, how old is your cousin? I just wonder if fixing it means having an operation? Any kind of procedures make my dads alzheimers worse!!! Are there not treatments or non surgical procedures to help with this?

Thanks again.

Wannabe

Hi Wannabe!

My cousin was 58 years old when she had the operation for cervical myelopathy.
I am 64 years young and, I'm holding off on the operation because, I read that some people have had some good results wearing a rigid neck brace to stretch and hold the neck in alignment to keep it from pinching the spinal cord. it can be worn during the day and removed at bedtime.
I am also thinking about trying accupuncture. I will try anything before getting surgery.
The doctor warned me, if I am dizzy too often, it damages the brain if ignored. If I get dizzy too often I will definately go and get the operation at Duke University Medical Center.